“Well, hurrah!” Lilian raised her glass. “The men have shown some sense. I’ll drink to that.”
“If all things were fair,” Sam said, “Celia would have been director. But there are some in the company who can’t swallow quite that much. Not yet. By the way, it’ll be announced tomorrow.”
Andrew got up and crossed the room to kiss Celia. “I’m happy for you, darling. You deserve it.”
“Well,” Celia told them all, “I’m not exactly upset. Thank you, Sam, and I’ll settle for ‘assistant.’” She added with a smile, “For the time being.”
They were interrupted by two small, pajama-clad figures who ran, laughing, into the living room. In the lead was Lisa, now twenty months old, lively and inquisitive, whom Andrew and Celia had brought with them and who—so they thought—had been put to bed for the night. Behind her was Juliet, the Hawthornes’ four-year-old and only child. Lilian had confided to Celia some time ago that doctors advised her she would never have more children, and she and Sam lavished love on Juliet, who was bright, intelligent and apparently unspoiled. The two little girls had clearly been excited by each other’s company.
Lisa hurled herself into her father’s arms. She told Andrew, giggling, “Julie chase me.”
Lilian got up. “I’ll chase you both. Right back to bed.” Amid laughter and shrieks the three disappeared in the direction of Juliet’s bedroom.
When Lilian returned, Celia said, “All of that reminds me of something. I may need a little time off from that new job after a while, Sam. I seem to be pregnant again.”
“This is a night for revelations,” Lilian said. “Fortunately there’s some booze left, so we can drink to that too.” There was, Celia thought, a trace of envy in the other woman’s voice.
8
Through the remainder of 1960, and into 1961, Celia immersed herself in teaching the Felding-Roth sales force how to sell.
Her new chief, the director of sales training, was a former division manager from Kansas City named Teddy Upshaw. When introduced, Celia recognized him at once. His had been one of the sympathetic faces when she was about to be ejected from the sales convention at the Waldorf.
Upshaw, a fast-talking, short-statured, dynamic whippet of a man in his late forties, had been selling drugs all his working life. He radiated energy, always hurried from one place to the next, and had a small round head which he nodded frequently during conversations; it gave the impression of a bouncing ball. Before being promoted to management, Upshaw had been the company’s top sales producer and confided to Celia that he still missed the life of a traveling salesman, which he described as “like easy breathing,” and added, “in this business you don’t have to sell dirty to be good because most docs know damned little about drugs, and if you’re straight with ’em, and they learn to trust you, you can have all the business you want. Only other thing to remember is to treat the docs like gods. They expect that.”
When Celia told Andrew in bed one night about the “gods” remark, he laughed and said, “Smart boss you have. Just remember to treat this doc that way at home.” She threw a pillow at him then, after which they wrestled playfully. The wrestling became something more, and they ended up making love. Afterward Andrew rubbed his hands over Celia’s belly where her pregnancy was beginning to show and he said, “Take care of this little guy, and remember while he’s in there—for you, no drugs of any kind!”
It was a caution he had expressed when she was pregnant with Lisa, and Celia said, “You feel strongly about that.”
“Sure do.” Andrew yawned. “Now let this god-doc get some sleep.”
On another occasion when Teddy Upshaw was talking with Celia he described “dirty selling” as “plain goddam stupid and not needed.” Just the same, he admitted, there was plenty of it in the pharmaceutical business. “Don’t think you and me are going to stop detail men saying what ain’t true, even at Felding-Roth. We won’t. What we’ll do, though, is show that the other way is smarter.”
Upshaw agreed with Celia about the need for sales training. He had been given almost none himself and picked up his scientific knowledge—a surprising amount, as she discovered—by self-education across the years.
The two of them got along well and quickly worked out a division of duties. Celia wrote training programs, a task Upshaw disliked, and he put them into effect, which he enjoyed.
One of Celia’s innovations was a staged sales session between a detail man and a doctor, with the former presenting one of Felding-Roth’s drugs and the latter asking tough, sometimes aggressive, questions. Usually Teddy, Celia or another staffer played the doctor’s role; occasionally, with Andrew’s help, a real doctor was persuaded to come in to add reality. The sessions proved immensely popular, both with participants and observers.
All new detail men hired by Felding-Roth were now given five weeks of training, while others already employed were brought to headquarters in small groups for a ten-day refresher. To everyone’s surprise, the older hands were not only cooperative but keen to learn. Celia, who also gave regular lectures, was well liked. She discovered that detail men who had been at the Waldorf sales meeting referred to her privately as “Joan of Arc” because, as one explained, “while Jordan wasn’t burned for heresy, she came damn close.”
When Celia thought about the sales convention she realized, in retrospect, how lucky she had been and how close she had come to wrecking her career. At times she wondered: if Sam Hawthorne had not spoken up, defending her, if she had been expelled from the convention and afterward lost her job, would she have regretted acting as she did? She hoped not. She also hoped she would have the same kind of fortitude in future in whatever other confrontations lay ahead. For the moment, though, she was happy with the outcome.
In her new job Celia saw a fair amount of Sam Hawthorne because, while Teddy Upshaw reported to him officially, Sam took a personal interest in the training program and was aware of Celia’s contribution.
Less harmonious was Celia’s relationship with the director of research, Dr. Vincent Lord. Because of the need for scientific help with sales training information, the Research Department had to be consulted frequently, something Dr. Lord made clear was an imposition on his time. Yet he refused to delegate responsibility to someone else. During one acerbic session with him Celia was told, “You may have conned Mr. Camperdown and others into letting you build your little empire, but you don’t fool me.”
Staying calm with an effort, she replied, “It isn’t my ‘empire,’ I’m the assistant, not the director, and would you prefer to have scientific misinformation go out to doctors, the way it used to?”
“Either way,” Dr. Lord said, glaring, “I doubt if you would know the difference.”
When she reported the conversation to Upshaw, he shrugged and said, “Vince Lord is a first-class prick. But he’s a prick who knows his science. Do you want me to talk to Sam and get him kicked in the butt?”
“No,” she said grimly. “I’ll handle him my own way.”
Her way involved collecting more insults, but at the same time learning and, in the end, respecting Vincent Lord’s competence. Though only seven years older than Celia—he was thirty-six—his impressive qualifications included a B.S. with honors from the University of Wisconsin, a Ph.D. in chemistry from the University of Illinois, and membership in several scientific honor societies. Vincent Lord had published papers while an assistant professor at U of I, papers describing his own significant discoveries—one concerning oral contraception had led to improvements in the Pill. What everyone expected, Celia learned, was that Dr. Lord eventually would achieve a major breakthrough by developing an important new drug.
But nowhere en route had Vincent Lord learned to be a pleasant human being. Perhaps, Celia thought, it was why he had remained a bachelor, though he was attractive enough physically in an ascetic, austere way.
One day, attempting to improve their relationship, she suggested they use first names, a practice common in the
company. He advised her coldly, “It would be better for both of us, Mrs. Jordan, to remember at all times the difference in our status.”
Celia continued to sense that the antagonism generated at their first meeting a year and a half earlier would remain a permanent part of their relationship. But despite it, and with Celia’s persistence, the contribution of the Research Department to sales training proved substantial.
Not that the plan to raise the standard of detailing was entirely successful or wholly accepted. It wasn’t. Celia had wanted to set up a report system, with spot checks of detail men’s performance obtained through confidential questionnaires. The questionnaires would be mailed to doctors on whom the detail men called. The suggestion went to the highest level and was vetoed.
Then Celia asked that letters of complaint about detail men sent in by doctors be routed to Sales Training and a record kept. She knew from her own contacts that such letters were mailed in, but no one in the company ever admitted seeing them, and presumably they were buried in some archive, with corrective action, if any, remaining secret. This request, too, was refused.
As Teddy Upshaw patiently explained, “There’s certain things the powers-that-be don’t want to know. You changed that some because when you stood up at our sales bash and spelled things out, and then Sam rescued you, they just weren’t hidden anymore, and the brass had to make the best of what was on their plate. But don’t push ’em too far too fast.”
It sounded uncannily like the advice Sam Hawthorne had given before her Waldorf speech and Celia retorted, “Someday the government is going to step in and tell us what to do.”
“You’ve said that before,” Upshaw acknowledged, “and maybe you’re right. Also, maybe it’s the only way.”
They had left it there.
The subject of drugs and the pharmaceutical industry was on other minds elsewhere.
Through much of 1960 the drug business was in the news almost daily—mostly unfavorably. The continuing U.S. Senate hearings, chaired by Senator Kefauver, were proving a gold mine for reporters and unexpected agony for companies like Felding-Roth. Both outcomes were due, in part, to skillful staging by the senator and his staff.
Like all such congressional hearings, much of the emphasis was on politics, with a bias decided in advance. As a Washington reporter, Douglass Cater, wrote, “They … move from a preconceived idea to a predetermined conclusion.” There was also, on the part of Estes Kefauver and his aides, a constant quest for headlines; thus their presentations were one-sided. The senator proved a maestro at disclosing sensational charges just before reporters had to leave the hearing room to file their stories—11:30 A.M. for afternoon papers, 4:30 P.M. for morning editions. As a result, rebuttals occurred with reporters absent.
Despite the unfairness, certain ugly truths emerged. They revealed excessive pricing of drugs; unlawful collusive price-fixing; illegally rigged bids for government contracts for supplying drugs; misleading advertising to physicians, including minimizing or even ignoring dangerous side effects; infiltration of the Food and Drug Administration by pharmaceutical companies and acceptance by one high-ranking FDA official of “honorariums” totaling $287,000 from a drug firm source.
Newspaper headlines, though sometimes one-sided, zeroed in on some abuses.
SENATORS FIND 1,118% DRUG MARKUP
—Washington Evening Star
SENATE PANEL CITES MARKUP ON DRUGS
Ranging to 7,079%
—New York Times
DRUG PERIL CLAIMED
—Miami Herald
BIG PROFIT FOUND IN TRANQUILIZERS
Chlorpromazine 6 Times Costlier
in U.S. than in Paris
—New York Times
Testimony revealed that drugs which had been discovered and developed in foreign countries were far cheaper in those countries than in the United States. This was absurd, it was pointed out, since the American companies marketing the drugs had incurred no development costs.
In French drugstores, for example, fifty tablets of chlorpromazine cost fifty-one cents compared with three dollars and three cents in the United States. Similarly, the U.S. price of reserpine was three times greater than in Europe where the drug was developed.
Another strange contrast was that American-made penicillin was selling in Mexico for two thirds of its retail price at home. These and other American prices, it was suggested, were high because of unlawful collusion between manufacturers.
PET FOOD SAID BETTER INSPECTED THAN DRUGS
—Los Angeles Times
F.D.A. AIDE’S TALK EDITED BY AD MAN
Drug Firm Slogan Written Into Speech
—New York Times
Testimony disclosed that a speech delivered by an FDA division head at an International Antibiotics Symposium had been sent to a drug company, Pfizer, for prior approval. An advertising copywriter changed the text to include, by inference, a plug for a Pfizer product, Sigmamycin. Later the drug company bought 260,000 reprints of the speech, treating it as an FDA endorsement.
The disagreeable newspaper headlines continued, sometimes on successive days, in big and small cities coast to coast, with TV and radio adding their reports.
All in all, as Celia expressed it to Andrew in December, “It hasn’t been a year for boasting about where I work.”
At the time, Celia was on leave of absence because their second child had been born in late October, again in accord with Celia’s schedule. As Andrew had been confident, it was a boy. They named him Bruce.
Both their lives had been made easier several months before by the advent of a young Englishwoman, Winnie August, who now lived in and took care of the children during their parents’ absence. Andrew had found her through an agency that advertised in medical journals. She was nineteen, had previously worked as a shop assistant in London and, as Winnie herself put it, she “wanted to ’ave a workin’ ‘oliday findin’ out what you Yanks are like, then maybe spend a couple o’ years down under with the Aussies.” She was cheerful, quick and, to Andrew’s great joy, whipped up breakfast each morning with lightning speed. “Comes o’ practice. Did it for me mum at ’ome,” she told him when he complimented her. Winnie also liked children and Lisa adored her. Andrew and Celia hoped that Winnie’s departure for Australia would be long delayed.
One other event that came to Celia’s attention happened near the end of 1960. The German drug Thalidomide—to be known in the U.S. and Canada as Kevadon—was submitted to the FDA for marketing approval. According to drug industry trade magazines, the Merrell Company, which now had North American rights, had large-scale plans for Thalidomide-Kevadon, believing the drug would be a huge seller, as it was continuing to be in Europe. The company was pressing FDA for swift approval. Meanwhile samples of the drug—officially for “investigative use,” though in fact without restriction—were being distributed to over a thousand physicians by enthusiastic Merrell detail men.
The news reminded Celia of her conversation with Sam Hawthorne eight months earlier when he had reported resentment within Felding-Roth because, at Celia’s suggestion, Thalidomide had been tested only on old people, then rejected. She wondered briefly if the resentment still remained, then dismissed the subject as unimportant.
She had other business concerns.
Following Bruce’s birth Celia returned to work more quickly than she had after Lisa was born and was back at Felding-Roth by mid-December. One reason: it was a busy time in Sales Training. The company was expanding and a hundred more detail men were being taken on—plus, at Celia’s urging, some detail women, though only a half dozen. Also contributing to her decision was an infectious sense of national excitement. In November John F. Kennedy had been elected president and it seemed—from the graceful rhetoric at least—as if a new era, stimulating and creative, had begun.
“I want to be part of it all,” Celia confided to Andrew. “People are talking about ‘a new beginning’ and ‘history in the making’ and saying it’s a time to be young a
nd in charge of something. Going back to work means being involved.”
“Uh-huh,” Andrew had said, almost indifferently, which was unusual. Then, as if realizing it, he added, “It’s okay with me.” But Andrew’s mind was not really on Celia’s endeavors; he was preoccupied with a problem of his own.
The problem concerned Dr. Noah Townsend, Andrew’s senior partner and the respected chief of medicine at St. Bede’s Hospital. Andrew had discovered something about Noah which, ugly and unpleasant, brought into question the older man’s competence to practice medicine.
Dr. Townsend was a drug addict.
9
Noah Townsend, now fifty-eight, had for many years appeared to represent everything a seasoned, experienced physician should be. He was conscientious, treating all who came to him, whether wealthy or poor, with equal concern. His appearance was distinguished; in manner he had always been courtly and dignified. As a result Dr. Townsend had a solid practice with patients who liked him and were loyal—with good reason, since he served them well. His diagnostic skills were regarded as remarkable. Townsend’s wife, Hilda, once told Andrew, “I’ve stood with Noah at a party and he’s looked across the room at a complete stranger and told me quietly, ‘That man is very ill and doesn’t know it,’ or another time, ‘That woman over there—I don’t know her name, but she’s going to die in six months.’ And he’s always been right. Always.”
Townsend’s patients felt much the same way. Some who exchanged anecdotes about his accurate diagnoses referred to him as “the witch doctor.” One even brought back from Africa, as a gift, a witch doctor’s mask which Townsend proudly hung on his office wall.
Andrew, too, respected the older doctor’s abilities. As well, there had grown up between the two a genuine and warm affection, not least on Andrew’s part because Townsend had, in all ways, treated his much younger colleague generously.
Contributing to Andrew’s respect was the fact that Noah Townsend stayed up-to-date medically through systematic reading, something many physicians of his age neglected. Yet Andrew had also noticed, over recent months, a certain vagueness at times on Townsend’s part, and occasional slurred speech. Then there had been those incidents earlier in the year of Noah’s apparently bizarre behavior. The combination of symptoms made Andrew uneasy, though he continued to rationalize that stress and tiredness could be their cause, since both doctors had been working hard, with heavy patient loads.